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General NPI Number Information
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NPI Number | 1477673549
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Entity Type | Organization
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Legal Business Name | CARDIO VASCULAR ASSOCIATES OF N.J., P.A.
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Dates
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Enumeration Date | 03/30/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 112 BLOOMFIELD AVE
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City | CALDWELL
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State | NJ
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Zip | 07006-5336
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Country | US
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Telephone | 973-364-1444
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Fax | 973-364-0101
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Provider Business Mailing Address
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Address Line | 112 BLOOMFIELD AVE
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City | CALDWELL
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State | NJ
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Zip | 07006-5336
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Country | US
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Telephone | 973-364-1444
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Fax | 973-364-0101
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. BRIDGET O'CALLAGHAN
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Credential |
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Telephone | 973-364-1444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 25MA02866900
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License Number State | NJ
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